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Strategies to Reduce Sodium Intake in the United States (2010)
Food and Nutrition Board (FNB)

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. "5 Sodium Intake Estimates for 2003–2006 and Description of Dietary Sources." Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press, 2010.

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Strategies to Reduce Sodium Intake in the United States

overreport their young children’s intake and be unable to estimate amounts accurately (Basch et al., 1990; Briefel et al., 1997; Devaney et al., 2004). Twenty-four hour recalls are also labor intensive to collect, and at least two non-consecutive days of data are needed to estimate usual intake.

Over the years, improvements in methodologies have been made as part of the National Nutrition Monitoring and Related Research Program (Woteki, 2003), and the quality and validity of data from 24-hour recalls have been improved. Efforts have focused on training dietary interviewers to use standardized probes to elicit complete and accurate reports of intake, using appropriate measurement aids to help respondents report amounts, and developing statistical adjustments to allow better estimation of usual intake (Dwyer et al., 2003). Nonetheless, the intake estimates for sodium derived from NHANES are likely to underestimate the population’s true total intake. However, despite the inherent measurement errors in dietary data collection and the underestimation of true total intake of sodium by the population, these measures provide useful and relevant information.

CURRENT SODIUM INTAKE OF THE U.S. POPULATION

For the purposes of this study, intake data from the NHANES covering 2003–2006 (i.e., combination of the 2003–2004 and 2005–2006 surveys) were used and designated as “current.” For analyses related to quantitative sodium intake, estimates are provided as usual intake (see Appendix E); analyses related to food categories as well as non-food contributions to the diet are reported as 1-day means, as is sodium intake from earlier NHANES.

As shown in Table 5-1, sources of dietary sodium include foods, salt added at the table, tap water, and dietary supplements. The sodium content of foods reflects salt added in cooking and food preparation. Methodologies for estimating table salt, tap water, and dietary supplements are described in Appendix E. Information on the contribution from medications was not available for the committee’s analysis. Drugs including anti-inflammatories, antacids, and laxatives can contribute to sodium intake.6 For example, sodium bicarbonate is often used to alleviate heartburn and acid indigestion.7,8 Although individuals with certain health conditions and their physicians may need to be concerned about the sodium content of some

6

Available online: http://www.megaheart.com/pdf/sodiuminmedications.pdf (accessed June 3, 2009).

7

Available online: http://www.medicinenet.com/sodium_bicarbonate-oral/article.htm (accessed November 11, 2009).

8

For example, commercial antacid tablets have 10 mg of sodium per two tablets (ingredient is sodium polyphosphate), according to the 2008 Nutrition Dietary System for Research database.

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122
Front Matter (R1-R12)
Summary (1-16)
1 Introduction (17-28)
2 Sodium Intake Reduction: An Important But Elusive Public Health Goal (29-66)
3 Taste and Flavor Roles of Sodium in Foods: A Unique Challenge to Reducing Sodium Intake (67-90)
4 Preservation and Physical Property Roles of Sodium in Foods (91-118)
5 Sodium Intake Estimates for 2003–2006 and Description of Dietary Sources (119-152)
6 The Food Environment: Key to Formulating Strategies for Change in Sodium Intake (153-212)
7 The Regulatory Framework: A Powerful and Adaptable Tool for Sodium Intake Reduction (213-234)
8 Committee's Considerations and Basis for Recommendations (235-284)
9 Recommended Strategies to Reduce Sodium Intake and to Monitor Their Effectiveness (285-296)
10 Next Steps (297-316)
Committee Member Biographical Sketches (317-324)
Appendix A: Acronyms, Abbreviations, and Glossary (325-334)
Appendix B: Government Initiatives and Past Recommendations of the National Academies, the World Health Organization, and Other Health Professional Organizations (335-356)
Appendix C: International Efforts to Reduce Sodium Consumption (357-404)
Appendix D: Salt Substitutes and Enhancers (405-408)
Appendix E: Background on the National Health and Nutrition Examination Surveys and Data Analysis Methods (409-416)
Appendix F: Sodium Intake Tables (417-442)
Appendix G: National Salt Reduction Initiative Coordinated by the New York City Health Department (443-452)
Appendix H: Federal Rulemaking Process (453-456)
Appendix I: Nutrition Facts Panel (457-458)
Appendix J: State and Local Sodium Labeling Initiatives (459-466)
Appendix K: Approach to Linking Universal Product Code (UPC) Sales Data to the Nutrition Facts Panel (467-468)
Appendix L: Public Information-Gathering Workshop Agenda (469-472)
Index (473-494)